As she puts Zola to bed, Meredith wonders what if she'd said or done one little thing differently that changed everything. She falls asleep still asking herself, "What if..."
Meredith awakens and joins her mother in the kitchen. She tells her she'll ride to work with dad. Richard appears. He's the dad.
At the hospital, Derek helps his pregnant wife Addison into her seat at the staff meeting. Owen and Callie situate their infant twins and toddler daughter outside the room and join the others. Ellis starts the meeting which includes an unmotivated Derek only having one surgery, an argument between Arizona and Callie over an artificial lung Callie's putting in a boy, and a shy Bailey having her surgery taken from her by Ellis. After the meeting, Callie confides to Addison that Owen's PTSD seems better - some guy named Teddy is helping him.
In the staff room, Meredith shows April her engagement ring. Meredith teases April about Charles liking her. Charles appears and they clam up. Christina enters and Jackson greets her. Meredith tells him not to feed the animals. Alex arrives wearing geeky glasses and full of enthusiasm. Once alone, he and Meredith make out.
In the hallway, Richard encourages Derek to pursue a clinical trial, but he has no energy for it. Meredith greets Derek at the elevator but he grunts and walks away. She calls him an ass.
A tattooed, pierced trauma case is wheeled into the ER unconscious - it's Lexie Grey. She awakens to Jackson telling her she overdosed. She gives her name as Lucille Ball. Christina stops in with an informative brochure. Lexie snarks that she's a ray of sunshine. Lexie tells Jackson her parents are dead and her half-sister works there but doesn't know her. When Lexie shows her medical knowledge, Jackson encourages her to go to school.
Ellis speaks to the press in the foyer and then chastises Meredith for being so busy getting engaged that she missed out on a cardiac surgery. Alex corners Bailey, saying he's stoked about their surgery, but she says Ellis took it. Alex asks to scrub in and Ellis allows it. Alex tells Bailey she needs to learn to speak up. In another room, Callie and Arizona hug over the artificial lung working for the boy. Meredith finds Richard, who gives her some insight on her mother pushing her to do things.
Addison is called to a difficult birth and pages Derek to the OR - the baby has a tumor. While looking at the x-rays, Derek and Addison bicker. They go into surgery and continue arguing. Addison says Derek is never home. After, Addison asks if Derek even wants their baby and if he loves her. He can't say it without looking at the floor. After, Ellis reads Derek the riot act.
The residents watch Christina in the lunch room and laugh at her. They remember crazy Izzy who got fired for dating a patient and stealing a heart for him. Meredith approaches Callie and says her mother suggested she assist on her cardiac surgery. Callie says she and Yang can split it. When Christina finds out, she looks for Meredith, but finds Alex canoodling with April! Alex follows Christina who demands he get Meredith off her surgery or else. Christina argues with Owen about a surgery and Owen smashes a glass window in anger. Christina stitches him up. He asks her not to tell Callie. Owen is called because of a drug theft. Jackson realizes Lexie did it.
Alex is going into surgery with Ellis when Bailey warns him the veins may be no good. Alex starts the surgery and Ellis tells him where his wedding will be held. The patient's veins collapse and Ellis angrily calls for Bailey when Alex denies knowledge of it. Bailey says it's the reason she picked the jugular, making Ellis furious since the press is watching her operate.
In surgery, Meredith and Christina argue. Christina prevails. They go to the staff room and continue fighting. Meredith taunts Christina about driving Dr. Burke away. Christina blurts that Alex and April were fooling around. April cries and Meredith walks out and sobs to Richard. Ellis appears and scolds Meredith for letting Yang show her up in surgery. Ellis watches Meredith leave and then cries to Richard that Bailey showed her up - she has to be fired. He talks her down, and finds Meredith. She tells him Ellis wants everyone to be small.
Arizona and Callie make plans to get a drink sometime, and Owen stops Christina in the hall to thank her for covering for him - Callie would take his kids. Mark Sloane enters carrying Lexie, who he found in the street unconscious. He, Jackson, and Christina save her, but she codes again. Meredith helps save her life.
In a staff room, Mark is changing when Addison blurts to Derek that the baby isn't his. He realizes it's Mark's. Down the hall, Bailey finds Alex crying over screwing everything up. She says she got fired, but she's not whimpering.
At the bar, Meredith drinks with Christina and they spar verbally. Derek appears and Meredith tells him the residents call him McDreary. They drink tequila together.
Spoilers for Next Week on Grey's Anatomy:
Valentine's Day is celebrated by the staff at Seattle Grace.
Well, I expected to love this episode and spend the whole time laughing over the different personalities and weird match-ups, but it actually turned out to be utterly depressing! Not fun at all. The silver lining is that it certainly made me appreciate the way things really are on the show! Can't wait for Valentine's Day - especially Bailey and Ben heating up!
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